[Fatigue and stress sensitivity of physicians after 16 hours on duty at the emergency department]

In addition to their 40-hour working week (Mon-Fri, 8 a.m.-4 p.m.) residents at the emergency department of the General Hospital of Vienna have to do approximately six 24-hour duties. The reasons for conducting the present field study were physicians' complaints about tiring night duties. 11 residents (4 women, 7 men; aged between 28 and 43 years, x = 33.5 +/- 4.9 years; working at the emergency department for 4-50 months, x = 31 +/- 20 months) were tested on an ordinary working day at 9 a.m. and midnight. Self-rating concerning sleep duration, perception of stress and workload on the days of the investigations were found to be representative of other prolonged duties. Subjects reported a usual nocturnal sleep duration of only 6-7 hours. Stress was regarded as moderate by most of the volunteers. Blood pressure and pulse rates did not show diurnal changes. Generally, residents felt significantly (p0.01) less awake at night than in the morning, but reported only slight vegetative and somatic stress reactions or annoyances as assessed by the Fahrenberg self-rating scale. Interindividual differences were found; residents who had been working at the emergency department for a longer period experienced a more pronounced impairment. Further studies are required in order to objectify a nocturnal decrease in vigilance (by means of computer-assisted EEG) and to evaluate potential performance deficits (by means of psychometric tests).